City of Bixby
Application Rec’d
Deposit Due
Event Fee Due
Date Paid
All events occurring within the City of Bixby, no matter how large or small, must complete a Special Event
Permit Application and receive approval from the City of Bixby Special Events Team before obtaining a
permit. Event Organizers are required to submit the Special Event Permit Application form a minimum of 45
days prior to the event. Please note late submissions may result in an automatic denial. Applications may be
approved, asked to make changes, or denied based on availability of facilities, services, dates, and/or logistics.
Any event taking place in the park without the authorization of the team will be asked to leave.
Prior to completing this application please read the Specials Events Guide and direct any questions to Jennifer
Rush, Public Information/Events Coordinator,
or 918-366-0417.
Organization Name *______________________________________________________________________
Name of the Event *_______________________________________________________________________
Date(s) of Proposed Event *_________________________________________________________________
Time(s) of Proposed Event *________________________________________________________________
Type of Event*
Festival Concert Food Block Party Fishing Parade
Fundraiser Community Private Business Sports (5K, Cycling, Basketball, etc)
Other __________________________________________________________________________________
Event General Location*
Washington Irving Park Charley Young Event Park Quail Creek Park
Bentley Park Bixhoma Neighborhood (Please list name)__________________________
Other (Please list address or location) _________________________________________________
Event Description *
Expected Attendance * Is this a new event? * Is the General Public invited? *
___________________ Yes No Yes No
Is there an admission fee to participate?* Yes No Amount? ____________________
Is there an admission fee to spectate?* Yes No N/A Amount? ____________________
Event Organizer Contact Name * ____________________________________________________________
Cell Phone* ____________________ Alternate Phone* ____________________
Email* _______________________________________________________________
Secondary Organizer Contact Name * ________________________________________________________
Cell Phone* ____________________ Alternate Phone* ____________________
Email* _______________________________________________________________
Organization Full Address* ________________________________________________________________
Event Social Media Pages* _________________________________________________________________
Organization Website* ____________________________________________________________________
Event Website* __________________________________________________________________________
Please list 2 to 3 sentences that describe the event to the General Public: *
Phone number for the General Public to inquire about the event: * _______________________________
Email or social media for the General Public about the event: *
Event set-up date(s) and time(s) requested * ___________________________________________________
Is the event a series? Yes No If yes, how frequently the event will occur? *
Does the event benefit another organization? * Yes No
If yes, please list: _________________________________________________________________________
Has the City of Bixby been added as a certificate holder to a Liability Insurance policy with an
aggregate limit of liability of not less than one million dollars ($1,000,0000) ? * Yes No
Will signage be used*? Yes No If yes, please describe: ____________________________________
Will there be live entertainment? * Yes No
Will a public announcement system be utilized? * Yes No
Will an event stage be utilized? * Yes No
Have adjacent property/business owners been notified? * Yes No
Will there be product sales (other than food or beverage) at the event? * Yes No
Will the event or vendors need access to electric? * Yes No
Will the event or vendors need access to water? * Yes No
Will the event need access to restroom facilities? * Yes No
If over 300 in attendance are expected, have you made arrangements for Porta Jon delivery? *
Yes No Delivery date: __________________________ Pickup date: __________________________
Will the event utilize tents? * Yes No
Have arrangements been made with a refuse service? * Yes No
Will carnival or other type rides be included in the event? * Yes No
If utilizing a City Park, please indicate the proposed location(s) to be utilized for the event *
Washington Irving Park
Bentley Park
Charley Young Park
Bixhoma Lake
Section 1
Section 2
Section 3
Section 4
Section 5
Section 6
Baseball Quad
Softball Quad
Soccer Complex
Basketball Courts
Splash Pad
Splash Pad
Food Truck Areas
Launch Dock
Fishing Dock
Launch Dock
Recreation Area
Picnic Area
Camping Area
Hiking Trail
Will the event need street closures? * Yes No
If yes, please list anticipated street closures: * _____________________________________________
Are barricades needed? * Yes No
If yes, please list requested barricade locations: * __________________________________________
Does the event have a plan for parking? * Yes No
If yes, please list parking information including location: * __________________________________
Will volunteers be utilized to assist with parking? * Yes No
Will the event utilize a shuttle service? * Yes No
Will the event require security or traffic assistance from the Bixby Police Department? * Yes No
If yes, have you contacted the police department to obtain approval to hire off-duty officers?
* Yes No
If no, has the event made arrangements for security from another provider? * Yes No
Is the use of a helicopter being planned? * Yes No
Will fireworks or other pyrotechnics be used during the event? * Yes No
Will the event provide on-site medical or first aid care? * Yes No
Will the event involve any type of firearm or replica firearm? * Yes No
Will any Hazardous Materials be present at the event? * Yes No
If the event is a run, ride, or parade will there be a marked lead vehicle and/or rear vehicle? * Yes
No N/A
Will food be provided at the event? * Yes No
If yes, who will be providing food at the event?
Food Trucks Sponsoring Organization Tented Vendors
Other ______________________________________________
Do vendors all have proper Oklahoma State Department of Health Food Permits?
* Yes No
Do vendors all have a City of Bixby Food Permit issued by the Tulsa County Health Department?
* Yes No
Will vendors be notified that they must receive an itinerant vendor license with the City of Bixby within
15 days of the event? (This excludes Tier 1 events.)
* Yes No
Will food vendors need access to food truck parking at the Park?
* Yes No
Will alcoholic beverages be served/sold at the event? * Yes No
If yes, who will be providing alcoholic beverages at the event?
Food Trucks Sponsoring Organization Tented Vendors
Other _______________________________________________
If alcohol will be sold or served, has proper permitting through ABLE commission been obtained?
Yes No
Event Site Plan*
Route Maps for Runs, Rides, and/or Parades
Event Public Safety & Parking Plan
Certificate of Insurance*
IRS Not-for-Profit Determination Letter
Press Releases
Event Flyers, Brochures, and/or Social Media Graphics
Vendor Lists
I, _____________________________, have reviewed the City of Bixby Special Events Guide.
As event organizer, I will ensure all event volunteers and organizers are aware and adhere to the
special event requirements and City of Bixby ordinances. I also understand that by submitting
this application my event is not automatically approved. I understand that I may be asked to
make changes before approval. I also understand that my event may not meet City of Bixby
guidelines and therefore my application may be denied. I certify that the information submitted
in this application is true and to the best of my knowledge correct. I acknowledge that I
understand event fees are non-refundable and refundable deposit fees may be refunded if
guidelines established in the Special Events Guide are met. I also certify that I am authorized to
commit the Host Organization to the aforementioned event and agree to be financially
responsible for any costs and fees that may be incurred by the Event or Organization to the City
of Bixby. I also understand that I must have a copy of the permit awarded at the event and may
be asked to leave if the permit is not available for viewing by a City of Bixby representative.
____________________________________ __________________________
Signature Date